DATE OF STUDY: MM/DD/YYYY
INDICATION FOR STUDY: Hyperextension injury.
TECHNIQUE AND FINDINGS: This MRI is performed in the usual fashion without contrast. We see on today’s examination that both menisci are intact. A small amount of high signal within the posterior medial meniscus is seen, of a linear nature, but no clear articulation to the surface is present to indicate a full-thickness tear. Small partial horizontal tear may be present, but it could also be some degenerative change.
Again, the articulation of the tear, peripherally, is suggested only in the most peripheral aspect on the sagittal images only. It is not confirmed on the coronal images. We see no osteochondral defect of the femoral condyle. There is significant high signal of the posterior patellar chondral surface and a small focal irregularity noted laterally, of the posterior patellar surface. This may be related to some chondral bruising.
We see that there is part of the ACL fibers still intact in their oblique longitudinal position. Some of the fibers are not present, particularly in the mid to inferior component, representing what is most likely a significant partial tear. The PCL is intact. There is an approximately 5-6 mm ovoid density seen directly adjacent to the ACL and in front of the PCL within the central portion of the joint space. This could represent some fragment of the ACL fibers or represent an osteochondral loose joint body.
The donor site is not definite on this examination; although, it may involve that posterior area of the lateral patella. Not all images, special attention to the T2 weighted axial images, suggest a definite defect of the posterior patella.
The collateral ligaments are intact. Minimal joint effusion is present. Patellar tendon and quadriceps tendon are intact. A small amount of high signal involving the proximal patellar tendon just inferior to the patellar bone itself suggests some edema within the tendon. It may indicate a small bruising or contusion. It is grossly intact however. No Baker’s cyst is noted.
IMPRESSION:
1. The anterior cruciate ligament does show some grossly intact remaining fibers. However, there is thinning and some edema from the mid section to the inferior insertion point indicating a definite partial tear.
2. Directly adjacent to the anterior cruciate ligament and in front of the posterior cruciate ligament is an ovoid density of uncertain etiology. This could be a loose joint body, probably from chondral surface, or could represent some of the anterior cruciate ligament fibers, which are displaced and bundled to that position.
3. No definite meniscal tear is seen. There is a possible small and posterior peripheral horizontal tear, of a partial nature, involving the posterior medial meniscus.
4. There is a small irregularity and some probable contusion of the posterior patellar chondral surface that is seen best on the sagittal images.
5. Some high signal involving probable strain or bruising of the cephalad component of the patellar tendon is noted, but no evidence of significant tearing is seen.
